The operative peritoneal fibrinolytic response to abdominal operation.

OBJECTIVE

To measure changes in the fibrinolytic properties of human peritoneum during operation.

DESIGN

Open study.

SETTING

University hospital, UK.

SUBJECTS

20 patients undergoing elective operations for non-inflammatory disease.

INTERVENTIONS

Peritoneum was biopsied at the beginning and end of operation.

MAIN OUTCOME MEASURES

Peritoneal plasminogen activating activity (PAA) and the concentrations of tissue plasminogen activator (t-PA), urokinase, and plasminogen activator inhibitors 1 and 2 were measured at both time points.

RESULTS

Peritoneal PAA was reduced over the time of the operation (p < 0.05) as was the concentration of t-PA (p < 0.05). The urokinase concentration rose significantly (p < 0.05), but plasminogen activator inhibitors 1 and 2 were not detected.

CONCLUSIONS

Elective abdominal operation caused an immediate reduction in peritoneal PAA which seemed to be secondary to a reduced concentration of t-PA. Such a reduction in peritoneal fibrinolytic activity allows the early deposition of fibrinous deposits within the peritoneal cavity.